Is postictal electrical silence a predictor of response to electroconvulsive therapy?

Electroconvulsive therapy (ECT) is an established effective treatment modality for patients with severe depression. Recent studies have focused on developing predictors of response. In this prospective study, using percent decrease in Hamilton Depression Scale (21 items) as the outcome measure, we blindly evaluated 33 inpatients with major depression to determine whether postictal suppression, the electrical silence following induced seizure, would predict treatment response to ECT.

Psychosocial correlates of eczema in a non-treatment-seeking population.

Data from the Vietnam Experience Study were used to examine psychosocial correlates of eczema. Based upon the results of dermatologic examinations, three groups of male veterans were identified: (a) subjects with eczema (n = 80), (b) subjects with tinea (n = 282), and (c) subjects with no medical diagnosis (n = 176). These three groups were compared on measures of anxiety, depression, hostility, and social support.

Amniotic fluid meconium: a fetal environmental hazard.

Objective: To investigate the hypothesis that meconium aspiration syndrome, the major hazard of meconium during labor, may be associated with superimposed fetal acute acidemia.

Methods: Umbilical artery blood gases were measured in 7816 term pregnancies with meconium in the amniotic fluid (AF) and the results were correlated with intrapartum and neonatal outcomes.

Results: Sixty-nine (1%) infants developed meconium aspiration syndrome and 31 (45%) of these were in association with fetal acidemia at birth.

Variability of repeated serum prostate-specific antigen (PSA) measurements within less than 90 days in a well-defined patient population.

Objectives: To determine the variability of repeated serum prostate-specific antigen (PSA) measurements within less than 90 days in a well-defined patient population.

Methods: A retrospective review of the PSA database at the Dallas Veterans Affairs Medical Center in Dallas was performed to identify patients who had two serum PSA measurements within less than 90 days, with the first PSA being less than 10 ng/mL (monoclonal assay, Abbott IMx). Patients' age and the dates and results of the PSA 1 and 2 measurements were captured in a database.

Dietary helplessness and disinhibition in weight cyclers and maintainers.

Objective: The primary purpose of this study was to compare obese versus nonobese adults and weight cyclers versus maintainers on measures of dietary helplessness, nutrition concern, dietary restraint, and disinhibition.

Method: Dietary helplessness, nutrition concern, dietary restraint, and disinhibition were assessed in 385 healthy obese and nonobese men and women in the RENO Diet-Heart Study, a 5-year prospective investigation of cardiovascular risk factors, weight cycling, and lifestyle.

Results: The results indicated that dietary helplessness and disinhibition were significantly greater in obese individuals, subjects with a history of weight cycling, and weight fluctuators (prospectively measured).

New directions for the education of clinical psychologists: The primary care setting, the VA's PRIME program, and the in-depth generalist model.

As part of this special issue on psychology in primary care settings, we describe the Department of Veterans Affairs' (VA's) new approach to education for practice in the primary care setting and we concurrently address some general issues related to the education of clinical psychologists for practice in this setting. In this article we argue that the primary care psychologist, in parallel with the generalist in medicine, must have a strong generic background in clinical psychology in order to gain the broad range of clinical skills necessary to function effectively as an "in-depth generalist" (IDG) who is capable of addressing the variety of psychological issues that emerge in the primary care setting. The IDG model of professional practice, which we believe is best suited for primary care/managed care settings, requires extensive training in generic clinical skills and increased time devoted to its implementation at both the predoctoral and the postdoctoral levels.

Racial and ethnic patterns in firearms deaths.

In the United States, there is currently an epidemic of firearms violence. Among victims of this violence, there are striking racial and ethnic patterns in the manners and circumstances of death. This study was conducted to explore and quantitate some of these differences.

Focal masses in cirrhotic liver: CT and MR imaging features.

The development of hepatic cirrhosis triggers attempted repair through regenerative nodules of parenchyma among bands of scar tissue. Some authors believe that this regeneration initiates an evolutionary process that may lead to nodular enlargement and cellular dedifferentiation to malignancy. Both the destructive and reparative processes in cirrhosis produce changes that the radiologist must recognize when imaging the cirrhotic liver.

Meconium: a 1990s perspective on an old obstetric hazard.

Objective: To quantify the current perinatal consequences associated with intrapartum detection of meconium in the amniotic fluid (AF).

Methods: We compared retrospectively the outcomes in 8136 term singleton cephalic pregnancies with meconium and 34,573 similar pregnancies with clear AF.

Results: Virtually all measures of adverse fetal-neonatal outcomes were significantly increased with meconium.

Acid secretion and serum gastrin in normal subjects and patients with duodenal ulcer: the role of Helicobacter pylori.

Objectives: To compare gastric secretory function in patients with duodenal ulcer and in healthy volunteers with and without Helicobacter pylori infection.

Methods: Basal acid output, peak acid output, meal-stimulated acid output, fasting and meal-stimulated serum gastrin concentrations were measured in 136 healthy volunteers (63 H. pylori positive, 73 H.

Anomalous origin of the left circumflex coronary artery from the right aortic sinus: a familial clustering.

Origin of the left circumflex coronary artery from the right sinus of Valsalva or the right coronary artery is a well-described anomaly. We report 3 cases which suggest a familial association of this anomaly. The familial clustering that we report has not been previously demonstrated.

Filling defects in the pancreatic duct on endoscopic retrograde pancreatography.

Filling defects in the pancreatic duct are a frequent finding during endoscopic retrograde pancreatography (ERP) and have a variety of causes. Some filling defects may be artifactual or related to technical factors and, once their origin is recognized, can be disregarded. Others may be due to acute changes of pancreatitis and should prompt more careful injection of contrast material into the duct.

Birth weight threshold for postponing preterm birth.

Objective: The study was designed to determine the birth weight threshold at which obstetric efforts intended to delay delivery might potentially improve rates of neonatal morbidity and mortality among pregnancies delivered after spontaneous preterm labor or rupture of the membranes.

Study Design: We studied 1147 singleton infants with birth weights between 1000 and 2499 gm and whose only complication was spontaneous preterm labor or preterm rupture of the membranes. The Mantel-Haenszel chi 2 statistic was used to evaluate trends for neonatal mortality and several indexes of morbidity.

Process safety management: resources from the American Institute of Chemical Engineers for use by industrial hygienists.

Industrial hygienists often work closely with engineers to control occupational safety and health hazards. This working relationship involves an educational process in which both engineers and industrial hygienists learn from one another. The Center for Chemical Process Safety (CCPS) of the American Institute of Chemical Engineers (AIChE) is expanding the opportunity for interdisciplinary cooperation and education by producing a series of guidelines publications on the technical and scientific issues critical to preventing and mitigating major releases of toxic materials.

Preventing relapse in the treatment of nicotine addiction: current issues and future directions.

Although smoking-cessation rates have continued to increase, the vast majority of smokers who quit eventually relapse. Between 1974 and 1985, over 1.3 million smokers quit during each of those years.

Affect regulation, nicotine addiction, and smoking cessation.

Numerous investigators have examined the role of negative affective states and affect regulation in the initiation and development of cigarette smoking behavior, smoking cessation, and relapse prevention. Affect regulation refers to any attempt to alleviate negative mood states by means of pharmacologic-, cognitive-, behavioral- or environmental-change methods. The psychological construct/process of affect regulation is examined in relation to (1) the initiation, development, and maintenance of the cigarette smoking habit; (2) the process of quitting smoking; and (3) the long-term maintenance of smoking abstinence versus relapse.

Preventing relapse in the treatment of nicotine addiction: current issues and future directions.

Although smoking-cessation rates have continued to increase, the vast majority of smokers who quit eventually relapse. Between 1974 and 1985, over 1.3 million smokers quit during each of those years.

Adenocarcinoma of the small bowel in lynch syndrome II.

Adenocarcinoma of the small bowel is rare and accounts for about 1% of all gastrointestinal tract cancer. This disorder has been identified in association with Crohn's disease, celiac disease, Peutz-Jegher's syndrome, and familial adenomatous polyposis. We report adenocarcinoma of the small bowel in nine patients from eight Lynch syndrome II extended pedigrees.

Hostility as a health risk factor: relationships with neuroticism, Type A behavior, attentional focus, and interpersonal style.

In order to investigate further the psychological construct of hostility measured on the Cook-Medley (Ho) Scale as a health risk factor, the present study examined relationships between hostility assessed on the Ho Scale and several measures of neuroticism, Type A behavior, and attentional and interpersonal style, using bivariate and hierarchical multiple regression analyses. Subjects were 204 psychologically normal, physically healthy males. Significant relationships were found between hostility, neuroticism, attentional overload, and interpersonal alienation.

Affect regulation, nicotine addiction, and smoking cessation.

Numerous investigators have examined the role of negative affective states and affect regulation in the initiation and development of cigarette smoking behavior, smoking cessation, and relapse prevention. Affect regulation refers to any attempt to alleviate negative mood states by means of pharmacologic-, cognitive-, behavioral- or environmental-change methods. The psychological construct/process of affect regulation is examined in relation to (1) the initiation, development, and maintenance of the cigarette smoking habit; (2) the process of quitting smoking; and (3) the long-term maintenance of smoking abstinence versus relapse.